Prevalence of Trachomatous Trichiasis in Ten Evaluation Units of Embu and Kitui Counties Kenya
Late-stage blinding sequalae of trachoma such as trachomatous trichiasis TT typically take decades to develop and often do so in the absence of ongoing ocular Chlamydia trachomatis infection. This suggests that most TT risk accumulates in early life as a result population-level TT incidence and prevalence can remain high years after C. trachomatis transmission among children has decreased. In Embu and Kitui counties Kenya the prevalence of trachomatous inflammation follicular is low in children
In this survey we set out to determine the prevalence of TT in ten evaluation units EUs in these counties
We undertook ten cross-sectional prevalence surveys for TT. In each EU people aged 15 years were selected by a two-stage cluster sampling method and examined for TT. Those with TT were asked questions on whether they had been offered management for it. Prevalence was adjusted to the underlying age and gender structure of the population
A total of 18987 people aged 15 years were examined. Per EU the median number of examined participants was 1656 range: 1451 3016 and median response rate was 86 range: 81 95. The prevalence of TT unknown to the health system in people aged 15 years was above the threshold for elimination 0.2 in all ten EUs studied range: 0.20.7. TT was significantly more common in older than younger individuals and in women than in men
The survey data presented here suggest the prevalence of TT unknown to the health system was above the threshold for elimination as a public health problem 0.2 in people aged 15 years7 in all ten surveyed EUs of Embu and Kitui counties. This suggests that an ongoing public health response to TT is warranted. The response could include for example active case finding and management and improvement of awareness of surgical services. Planning such services can be supported by rough estimation of case numbers. If we take the combined estimated population of each of these EUs in 2018 and assume 58 of that population is 15 years as indicated by 2009 census data18 we estimate that there are 3900 individuals living in these EUs with TT who have yet to be identified and offered management by the health system although the inaccuracy in such estimates is well described.20 It is also notable that of the 2272 people offered trichiasis surgery in Embu and Kitui counties by the KTEP up to 2019 there were 64 individuals who refused. It is important to understand the reasons behind these refusals to support programme staff to maximise uptake. It should also be noted that Kitui has roughly double the population of Embu but has carried out more than ten-times the number ofrntrichiasis operations. Embu has one of the lowest numbers of surgeries conducted of any county. This highlights the necessity to ensure programmes are delivered equitably
Publication Information
Focus County(s):
Kitui County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
Disease Domain(s):
Trachomatous Trichiasis
Document History:
Publication Date: 17.Jan.2022
Conference Title: